A treatise on etherization in childbirth : Illustrated by five hundred and eighty one cases / By Walter Channing.

  • Channing, Walter, 1786-1876.
Date:
1848
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Licence: Public Domain Mark

Credit: A treatise on etherization in childbirth : Illustrated by five hundred and eighty one cases / By Walter Channing. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    Case of Puerperal Convulsions. By Samuel Cabot, M.D. Mrs. II. strong and healthy, twenty-seven years of age. Married at seventeen ; mother of four children. Always has had very short and easy labors of about ten minutes' duration. Supposed herself to be at about the full period of gestation. Fell upon back with considerable violence, about a week before, and had had some nausea, with uneasiness in head, from that time. At 8, p.m. March 13th, was found upon the bed in a violent convulsion, blood flowing in considerable quantity from mouth; convulsions recurring every fifteen minutes. At 9, I saw her. The muscles of head, chest, and arms, principally affected, diaphragm also; left side rather more than right. Left pupil dilated. Head of child very high, and mouth of womb not felt. Took sixteen ounces of blood from arm. Applied ice to head, and sinapisms to feet. Pulse strong and full before venesection; small and feeble after. In about thirty minutes after venesec- tion, recovered senses for a short time, so as to answer questions coherently. Had another convulsion at an hour and a half after venesection. Bled her again at a quarter past 11, eighteen ounces. After venesection, quite pale; pulse small and weak; pupils fixed, and rather contracted, but equally. In an hour, had another fit; and one each successive hour, for three hours; then becoming oftener, until once in twenty minutes. At half-past 3, a.m. 14th March, I applied, at the apparent commencement of a convulsion, a sponge, saturated with sulphuric ether over her mouth and nose. The spasmodic action soon ceased; and, in about three minutes, she was in a deep sleep. Upon examination, head of child somewhat advanced; could only reach anterior part of neck of womb; rather soft, and much shortened. Ether was used at every threatening of convulsion. Almost immediately after patient was obviously etherized, regular labor-pains commenced, and continued at short intervals, until, at 6, a.m. the child was born. I think, any one, ignorant of the circumstances of the case, who had come in while the head of the child was passing the external organs, would have thought, from the expression of the mother's face, that it was an ordinary case of labor. The child cried almost immediately after the passage of the head. Boy, large; cord very large; placenta normal. The child, some hours after, did not smell of ether. One scruple of ergot was administered, as womb did not contract well. After birth of child, patient slept quietly about an hour; then had another convulsion, there having been an interval of nearly four hours since last spasm. Ether was again used; but pulse became so feeble and small before any effect could be produced, that it was discontinued; and an enema of tinct. opii, one dram, and pulv. asafoetid. one dram, in half a cup of starch, was administered; and hyd. submur. fifteen grains, given by the mouth. After this, patient slept quietly for three hours; then had a convulsion every half hour, until 2, p.m. ; when, after considerable difficulty, got down tinct. opii, thirty drops; pulv. asafeet. ten grains. Had one more convulsion soon after taking it, and then slept quietly for two hours; and then, beginning to move as if about to have a convulsion, I gave her tr. op. and asafoetida, as before ; and, after a few struggles not amounting to convulsion, became again quiet, and remamed so until about half-past 5, when, after having taken some senna and salts, convulsions again came on ; the first continuing about half an hour, and hardly ceasing before another commenced, which lasted about the same time ; then there was a short interval, and then another not severe convulsion; after which, she had no return of them. At 9, took a teacup of infusion of senna; then slept quietly till 10, when medicine operated; after which, slept until half-past 9, March loth, when took a little food, and answered rationally. Very feeble. Tongue very sore, having been wounded in several places. Lochia abundant. On the 50